脑星形细胞瘤3T MRI 3D多体素1H-MRS术前分级及病理对照研究  

Brain Astrocytoma：3T MRI 3D Multivoxel 1H-MRS in Preoperative Grading and Pathological Findings

作　　者：楼晓剑[1] 蒋定尧[2] 倪丽欣 俞高龙[1] 

机构地区：[1]解放军第一一三医院放射科,浙江宁波315040 [2]浙江大学医学院附属第二医院放射科,浙江宁波310040

出　　处：《中国CT和MRI杂志》2015年第11期16-20,25,共6页Chinese Journal of CT and MRI

摘　　要：目的研究脑星形细胞瘤的3T MRI 3D多体素1H-MRS表现,通过分析NAA,Cho,Cr,Lac and Lip,NAA/Cr,NAA/Cho,Cho/Cr比值变化,初步探讨脑星形细胞瘤1H-MRS术前分级诊断及与其病理级别相关性。方法收集浙江大学医学院附属第二医院和解放军第一一三医院经手术及病理证实的45例脑星形细胞瘤患者MRI资料,其中高级别脑星形细胞瘤组28例,低级别脑星形细胞瘤组17例。通过计算NAA/Cr,NAA/Cho,Cho/Cr等比值,分析脑星形细胞瘤波谱表现及高低级别组间差异。结果脑星形细胞瘤肿瘤组织与对照侧正常脑组织的NAA/Cho,Cho/Cr,NAA/Cr比值存在显著性差异(P<0.05);NAA/Cho、NAA/Cr比值在高低级别脑星形细胞瘤瘤周近区存在显著性差异(P<0.05);NAA/Cho、NAA/Cr比值在高级别脑星形细胞瘤和低级别脑星形细胞瘤的肿瘤组织有统计学差异(P<0.05),肿瘤瘤体区NAA/Cho比值与肿瘤的级别呈负相关(r=-0.542,P<0.05),NAA/Cr与肿瘤级别负相关(r=-0.502,P<0.05),Cho/Cr比值与肿瘤的级别呈正相关(r=0.420,P<0.05)。结论 3D多体素1H-MRS能够为术前肿瘤分级提供定量诊断依据,脑星形细胞瘤的病理级别与其代谢物比值有相关性,具有重要临床应用价值。Objective This study was designed to approach the characteritics of astrocytoma 3D Mult-ivoxel 1H-MRS and the correlation with grading diagnosis in preoperative grading by analyzing the contents changes of major metabolites such as NAA, Cho, Cr,Lac and Lip in astrocytoma 1H-MRS, and jointly measuring ratio changes of NAA/Cr, NAA/Cho, Cho/Cr. Methods A total of 45 patients of brain astrocytoma which were confirmed by postoperative pathological results were gathered in the Second Affiliated hospital of Zhejiang University School of Medicine and PLA NO.113 hospital. Seventeen cases of low-grade astrocytoma（Ⅰ-Ⅱgrade）,28 cases of high-grade astrocytoma（Ⅲ-Ⅳ grade）. NAA/Cr, NAA/Cho, Cho/Cr, Lac/Cr ratio were computed. Results The mainly manifestation of brain astrocytoma 1H-MRS was significant differences in NAA/Cho, Cho/Cr, NAA/Cr between solid area of astrocytoma and normal-area of opposite side（P〈0.05）; There were significant differences in NAA/Cho, NAA/Cr in solid area of astrocytoma between low-grade astrocytoma group and high-grade astrocytoma group（P〈0.05）, There were significant differences in NAA/Cho, NAA/Cr in peritumoral edema area between low-grade astrocytoma group and high-grade astrocytoma group（P〈0.05）, Cho/Cr（r=0.420）of solid area of tumor was of positive correlation with the grade of tumor, and NAA/Cr, NAA/Cho（r=-0.502,-0.542）was of negative correlation. Conclusion 3D Multi-voxel 1H-MRS contributes to the clinical diagnosis of brain astrocytoma. The values of chemical composition ratio of tumor was correlation with the grade of tumor, which provide quantify diagnosis basis for grading of brain astrocytoma before surgery, to sum up, has very significance clinical application value.

关 键 词：脑星形细胞瘤 氢质子磁共振波谱 代谢物 分级诊断 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]